Witch hazel (Hamamelis virginiana) is a flowering shrub, native to Eastern North America although other related species exist in North America, Asia, and Europe. Witch hazel has traditionally been used as a facial cleanser/toner and for the treatment of skin irritations, bruises, hemmorrhoids, and to stop bleeding.

Early research has shown that the leaves, stems, and bark of witch hazel contain compounds which may have astringent, anti-irritant, antioxidant, and antiinflammatory properties.

Although witch hazel is widely available and has been used for a variety of medical conditions, there is currently little human evidence supporting how effective witch hazel is in treatment of many of these conditions.

These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.

GRADE *

Based on human study, witch hazel was less effective than hydrocortisone cream, and no more effective than placebo in relieving inflammation associated with atopic eczema. Additional studies are needed to confirm these results.

C

Witch hazel is a common ingredient in over-the-counter hemorrhoid preparations for the skin; however, human study evaluating the effectiveness for this indication is currently lacking.

C

A homeopathic formulation containing an extract of witch hazel and tinctures of other botanicals was studied for its effects in relieving redness and itching associated with mosquito bites. According to study results, the formulation did not provide effective relief from mosquito bite symptoms. However, because information about the strength or concentration of the witch hazel extract used was not available, and witch hazel was not evaluated alone, conclusions about the effects of witch hazel on insect bite symptoms cannot be made. Additional research is needed in this area.

C

Witch hazel has a long history of use for treating inflammation and hemorrhage when applied to the skin. Its use to reduce perineal discomfort associated with childbirth requires well-designed human study before recommendations can be made.

C

Although witch hazel has been commonly used to relieve minor skin irritations, there are few human studies evaluating its use for this purpose, especially in children. Witch hazel as an oil based formulation may be safe and well tolerated when applied to the skin in children with minor skin irritations. High quality human study is needed for a conclusion to be made.

C

Witch hazel has a long history of use for treating skin irritations. Human study evaluating the effects of witch hazel formulations applied to the skin have demonstrated some antiinflammatory effects. Until better quality studies are conducted, the efficacy of witch hazel for this indication cannot be determined.

C

Witch hazel has been studied for the treatment of varicose veins and improving venous tone. Additional study is needed in this area.

C

* Key to grades

A: Strong scientific evidence for this useB: Good scientific evidence for this useC: Unclear scientific evidence for this useD: Fair scientific evidence for this use (it may not work)F: Strong scientific evidence against this use (it likley does not work)

Tradition / Theory
The below uses are based on tradition, scientific theories, or limited research. They often have not been thoroughly tested in humans, and safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider. There may be other proposed uses that are not listed below.

Witch hazel has been used on the skin as an astringent, for first aid, facial cleansing, and inflammatory topical conditions in the following forms: compress, steam distillate (undiluted or diluted with water), poultice, gargle or mouthwash, salve, tincture, and fluid extract. Witch hazel suppositories, prepared with leaves or bark of witch hazel in combination with cocoa butter, have been used rectally or vaginally. Witch hazel can also be applied to toilet paper to wipe the anal area.

For the treatment of moderately severe atopic eczema, 5.35 grams of hamamelis distillate with 0.64 milligrams of ketone per 100 grams was used for 14 days.

For the treatment of ultraviolet light skin damage protection, the following single doses were used: 0.64 milligrams or 2.56 milligrams of witch hazel with ketone per 100 grams; pH5 Eucerin( Aftersun Lotion with 10% witch hazel; and 10% witch hazel distillate.

Children (under 18 years old)

For minor skin injuries/irritation, an oil based witch hazel preparation was applied to the skin in a thin layer several times daily.

Safety
The U.S. Food and Drug Administration does not strictly regulate herbs and supplements. There is no guarantee of strength, purity or safety of products, and effects may vary. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy. Consult a healthcare provider immediately if you experience side effects.

Allergies

Avoid with a known allergy or sensitivity to witch hazel.

Side Effects and Warnings

Witch hazel is recommended for use on the skin only. If redness or burning of the skin after use of witch hazel occurs, it is recommended to dilute with water. A healthcare provider should be contacted if symptoms of diarrhea or constipation persist while using witch hazel.

Use with caution in patients with liver or kidney disorders as witch hazel may potentially cause damage to these organs when taken by mouth in large doses.

Witch hazel may lower blood sugar levels. Caution is advised in patients with diabetes or hypoglycemia, and in those taking drugs, herbs, or supplements that affect blood sugar. Blood glucose levels may need to be monitored by a qualified healthcare professional, including a pharmacist, and medication adjustments may be necessary.

Use with caution in children, due to limited evidence of safety. In a study of children 27 months to 11 years of age with minor skin irritations, treatment with an oil based witch hazel preparation was well tolerated.

Pregnancy and Breastfeeding

Avoid in patients who are pregnant or breastfeeding, due to a lack of safety evidence.

Witch hazel may lower blood sugar levels. Caution is advised when using medications that may also lower blood sugar. Patients taking drugs for diabetes by mouth or insulin should be monitored closely by a qualified healthcare professional, including a pharmacist. Medication adjustments may be necessary.

Witch hazel may add to the effects of antibiotic, antifungal, antiinflammatory, antiviral, and antiulcer drugs.

Interactions with Herbs and Dietary Supplements

Witch hazel may lower blood sugar levels. Caution is advised when using herbs or supplements that may also lower blood sugar. Blood glucose levels may require monitoring, and doses may need adjustment.

Witch hazel may add to the effects of anti-inflammatory, antibacterial, antifungal, antiviral, antioxidant, antiulcer, or tannin containing herbs and supplements.

The information in this monograph is intended for informational purposes only, and is meant to help users better understand health concerns. Information is based on review of scientific research data, historical practice patterns, and clinical experience. This information should not be interpreted as specific medical advice. Users should consult with a qualified healthcare provider for specific questions regarding therapies, diagnosis and/or health conditions, prior to making therapeutic decisions.